Provider Demographics
NPI:1336231463
Name:DEJAMES, JOSEPH SEBASTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SEBASTIAN
Last Name:DEJAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1385
Mailing Address - Street 2:
Mailing Address - City:ST. JOHN
Mailing Address - State:VI
Mailing Address - Zip Code:00831
Mailing Address - Country:VG
Mailing Address - Phone:340-777-4637
Mailing Address - Fax:
Practice Address - Street 1:MYRAH KEATING SMITH COMMUNITY HEALTH CENTER
Practice Address - Street 2:3-B SUSSANABERG
Practice Address - City:ST.JOHN
Practice Address - State:VI
Practice Address - Zip Code:00831
Practice Address - Country:US
Practice Address - Phone:340-693-8900
Practice Address - Fax:340-693-9506
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208265207Q00000X
VI1149173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VIH01178Medicare UPIN